EP3253412B1 - Anti-cd40l antibodies and methods for treating cd40l-related diseases or disorders - Google Patents

Anti-cd40l antibodies and methods for treating cd40l-related diseases or disorders Download PDF

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EP3253412B1
EP3253412B1 EP16747111.9A EP16747111A EP3253412B1 EP 3253412 B1 EP3253412 B1 EP 3253412B1 EP 16747111 A EP16747111 A EP 16747111A EP 3253412 B1 EP3253412 B1 EP 3253412B1
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antibody
disease
cd40l
amino acid
acid sequence
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French (fr)
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EP3253412A4 (en
EP3253412A1 (en
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John M. Lincecum
Bingbing Jiang
Steven N. Perrin
Alan Gill
Cynthia A. GILL
Fernando G. Vieira
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ALS Therapy Development Institute
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Als Therapy Development Institute
ALS Therapy Development Institute
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    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/2875—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the NGF/TNF superfamily, e.g. CD70, CD95L, CD153, CD154
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    • C07K14/705—Receptors; Cell surface antigens; Cell surface determinants
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    • C07K16/2803—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily
    • C07K16/2827—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily against B7 molecules, e.g. CD80, CD86
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Definitions

  • Anti-CD40L antibodies compositions comprising the antibodies, and method of using same for treatment of CD40L-related diseases or disorders.
  • CD40 The interaction of CD40 with its ligand CD40L plays a critical role in regulating immune responses. Binding of CD40L to CD40 triggers activation of the CD40 pathway which up-regulates costimulatory molecules such as CD80 and CD86. Blockade of the interaction between CD40 and CD40L by monoclonal antibodies has been shown to result in protection from autoimmunity and graft rejection in various preclinical models. Recently, in a mouse model of amyotrophic lateral sclerosis, an antibody directed to CD40L was shown to delay disease onset and prolong survival the onset of disease. ( United States Patent No. 8,435,514 ).
  • WO 2010/065819 discloses methods for treating neurodegenerative diseases such as Amyotrophic Lateral Sclerosis, Alzheimer's Disease, Parkinson's Disease, Myasthenia Gravis, Multifocal Motor Neuropathy, Primary Lateral Sclerosis, Spinal Muscular Atrophy, Kennedy's Disease, and Spinocerebellar Ataxia, by administration of a compound that blocks the interaction of CD40 and CD40L.
  • neurodegenerative diseases such as Amyotrophic Lateral Sclerosis, Alzheimer's Disease, Parkinson's Disease, Myasthenia Gravis, Multifocal Motor Neuropathy, Primary Lateral Sclerosis, Spinal Muscular Atrophy, Kennedy's Disease, and Spinocerebellar Ataxia
  • the present invention provides an isolated antibody that binds to CD40L for use in treating a CD40L associated disease or disorder; wherein the antibody comprises a light chain and a heavy chain, wherein the light chain consists of the amino acid sequence of SEQ ID NO:7 and the heavy chain consists of the amino acid sequence of SEQ ID NO:9.
  • the anti-CD40L antibodies are suitable for use in humans and non-human primates, having an Fc domain that has been engineered to reduce or eliminate platelet aggregation and the concomitant risk of thromboembolism.
  • Described herein are antibodies that are humanized versions of the mouse anti-human CD40L antibody 5c8.
  • Also described herein is an antibody that comprises a human IgG1 consensus framework wherein the variable light chain and the variable heavy chain comprise the CDR sequences of 5c8.
  • Described herein is an isolated antibody that binds to CD40L and that comprises a light chain and a heavy chain, wherein (i) the light chain comprises a light chain variable region comprising an amino acid sequence having at least 95% sequence identity with SEQ ID NO:1; (ii) the heavy chain comprises a heavy chain variable region and an Fc region wherein a) the heavy chain variable region comprises an amino acid sequence having at least 95% sequence identity with SEQ ID NO:2; and b) the Fc region comprises an amino acid sequence having at least 95% sequence identity with SEQ ID NO:3 wherein the Fc region comprises one or a combination of substitutions selected from the group consisting of C11S, C14S, and P23S. Optionally the Fc region comprises a further amino acid substitution C5S.
  • Described herein is a method for treating a subject with a CD40L-associated disease or disorder comprising administering to the subject a therapeutically effective amount of an antibody described herein. Also described herein is a method for treating a subject with a neurodegenerative or neuromuscular disease or disorder; an inflammatory or immune disease or disorder; or an autoimmune disease, comprising administering to the subject a therapeutically effective amount of an antibody described herein. Also described herein is a method for treating a subject with a CD40L-associated disease or disorder comprising administering to the subject a therapeutically effective amount of an antibody administered in combination with a compound that blocks the interaction between CD28 and CD86 or between CD28 and CD80.
  • treatment includes therapeutic treatment and prophylactic treatment.
  • Therapeutic treatment is treatment of a subject that has signs or symptoms of the disease, condition or disorder to be treated.
  • Prophylactic treatments refers to treatment of a subject that is predisposed to the disease, condition or disorder that does not show overt signs of the disease, condition or disorder.
  • treatment may result in stasis of, partial or total alleviation, or reduction of signs or symptoms of illness, and specifically includes, without limitation, prolongation of survival.
  • compositions comprising A or B
  • the method must comprise at least one of A and B but may also comprise both A and B.
  • a composition comprising "A, B, C or D” must comprise at least one of the group of A, B, C and D, but may also comprise all or any combination of A, B, C and D.
  • Amino acid substitutions are denoted by the convention in which the original amino acid, the position of the amino acid in the specified sequence and the replacement amino acid are identified, for example, C11S would indicate that the cysteine at position 11 of the polypeptide sequence is replaced with a serine.
  • 5c8 refers to the mouse anti-human antibody that binds CD40L and is produced by the hybridoma that is available from the ATCC having the accession number HB10916 and is described in U.S. Pat. No. 5,474,771 .
  • hu5c8 refers to a humanized version of 5c8 the sequence of which is disclosed in Karpusas, et al., Structure vol. 9, pp 321-329, (2001 ).
  • identity refers to percent identity between polypeptide or amino acid sequences.
  • the percent identity between the two sequences is a function of the number of identical positions shared by the sequences, taking into account the number of gaps, and the length of each gap, which need to be introduced for optimal alignment of the two sequences.
  • Identity can be measured as "local identity” or "global identity”. Local identity refers the degree of sequence relatedness between polypeptides as determined by the match between strings of such sequences.
  • Global identity refers to the degree of sequence relatedness of a polypeptide compared to the full-length of a reference polypeptide. Unless specified otherwise, as used herein, identity means global identity. For the purposes of this disclosure, the percentages for global identity are calculated using Needleman and Wunsch ((1970) J. Mol.
  • CD40L is also known as CD154, gp39, T-BAM, 5c8 antigen, or TNF related activation protein (TRAP).
  • Described herein are therapeutic anti-human CD40L antibodies and methods for using the antibodies for treating patients with a CD40L-associated disease or disorder.
  • Various exemplary embodiments of the present invention are provided, however, the invention is to be limited by the claims and not the disclosed embodiments.
  • antibodies that are modified versions of the anti-CD40L antibody hu5c8 that comprise a human IgG1 consensus framework having the variable light chain and the variable heavy chain CDR sequences of hu5c8 with an Fc domain modified to prevent platelet activation.
  • Table 1 provides a description of the SEQ ID NOs referenced in the application.
  • Table 1 SEQ ID NO: Description of Sequence 1 Light chain variable region amino acid sequence (hu5c8 and JB5) 2 Heavy chain variable region amino acid sequence (hu5c8 and JB5) 3 Fc region amino acid sequence (hu5c8) 4 JB5 Fc region amino acid sequence 5 JB5-R28K light chain variable region amino acid sequence 6 JB5-K74R heavy chain variable region amino acid sequence 7 JB5 light chain amino acid sequence 8 JB5 light chain nucleic acid sequence 9 JB5 heavy chain amino acid sequence 10 JB5 heavy chain nucleic acid sequence 11 JB5-R28K light chain amino acid sequence 12 JB5-R28K light chain synthetic gene nucleic acid sequence 13 JB5-K74R heavy chain amino acid sequence 14 JB5-K74R heavy chain synthetic gene nucleic acid sequence 15 CDR-1 of the JB5 Variable Light Chain amino acid sequence 16 CDR-2 of the JB5 Variable Light Chain amino acid sequence 17
  • Described herein is an isolated antibody that binds to CD40L and that comprises a light chain and a heavy chain, wherein the light chain comprises a light chain variable region comprising an amino acid sequence having at least 90%, or at least 91%, or at least 92%, or at least 93%, or at least 94%, or at least 95%, or at least 96% or at least 97%, or at least 98% or at least 99% sequence identity with SEQ ID NO: 1 and the heavy chain comprises a variable heavy chain region and an Fc region, wherein the heavy chain variable region comprises an amino acid sequence having at least 90%, or at least 91%, or at least 92%, or at least 93%, or at least 94%, or at least 95%, or at least 96%, or at least 97%, or at least 98%, or at least 99% sequence identity with SEQ ID NO:2 and the Fc region comprises an amino acid sequence having at least at least 90%, or at least 91%, or at least 92%, or at least 93%, or at least 94%, or at least 9
  • Fc region further comprises the amino acid substitution C5S.
  • the antibody comprises a light chain variable region that does not comprise any of the substitutions T33W, S26D, and Q27E.
  • the light chain variable region comprises the substitution R28K.
  • the CDRs of the heavy and light chain have the sequences listed in Table 2 Table 2 CDR1 light chain ISCRASQRVSSSTYSYMH (SEQ ID NO:15) CDR2 light chain YASNLES (SEQ ID NO:16) CDR3 light chain QHSWEIPPT(SEQ ID NO:17) CDR1 heavy chain SYYMY (SEQ ID NO:18) CDR2 heavy chain EINPSNGDTNFNEKFKS (SEQ ID NO:19) CDR3 heavy chain SDGRNDMDS(SEQ ID NO:20)
  • the light chain variable region comprises the amino acid sequence ISCRASQRVSSSTYSYMH (SEQ ID NO:15).
  • the light chain variable region comprises the amino acid sequence ISCRASQRVSSSTYSYMH (SEQ ID NO:15) and both of the amino acid sequences YASNLES (SEQ ID NO:16) and QHSWEIPPT (SEQ ID NO:17).
  • the light chain variable region comprises the amino acid sequence of SEQ ID NO:1. In yet other embodiments the light chain variable region consists of the amino acid of SEQ ID NO:1. Described herein, the light chain consists essentially of the amino acid sequence of SEQ ID NO:7. In embodiments, the light chain consists of the amino acid sequence of SEQ ID NO:7. Described herein, the light chain comprises the amino acid sequence of SEQ ID NO:11. Also described herein, the light chain consists essentially of the amino acid sequence of SEQ ID NO:11. Described herein, the light chain consists of the amino acid sequence of SEQ ID NO:11.
  • the antibody comprises a heavy chain variable region that does not comprise any of the substitutions T30H, Y33W, or S54N.
  • the light chain variable region does not comprise any of the substitutions T33W, S26D, and Q27E.
  • the light chain variable region does not comprise any of the substitutions T33W, S26D, and Q27E and the heavy chain variable region does not comprise any of the substitutions T30H, Y33W, or S54N.
  • the heavy chain variable region comprises the substitution K74R.
  • the heavy chain variable region comprises the amino acid sequences SYYMY (SEQ ID NO:18), EINPSNGDTNFNEKFKS (SEQ ID NO:19), and SDGRNDMDS (SEQ ID NO:20).
  • the heavy chain variable region comprises the amino acid sequence of SEQ ID NO:2. In yet another embodiment the heavy chain variable region consists essentially of the amino acid sequence of SEQ ID NO:2. In still another embodiment the heavy chain variable region consists of the amino acid sequence of SEQ ID NO:2. Described herein, the heavy chain variable region comprises the amino acid sequence of SEQ ID NO:6. Described herein, the heavy chain variable region consists essentially of the amino acid sequence of SEQ ID NO:6. Described herein the heavy chain variable region consists of the amino acid sequence of SEQ ID NO:6.
  • Described herein is an isolated antibody, wherein the light chain comprises the amino acid sequence of SEQ ID NO:1 and the heavy chain consists of the amino acid sequence of SEQ ID NO:9.
  • Also described herein is an isolated antibody, wherein the light chain consists of the amino acid sequence of SEQ ID NO:7 and the heavy chain consists of the amino acid sequence of SEQ ID NO:9.
  • Described herein is an isolated antibody wherein the light chain variable region comprises the amino acid sequence of SEQ ID NO:5 and the heavy chain consists of the amino acid sequence of SEQ ID NO:9.
  • Described herein is an isolated antibody wherein the light chain consists of the amino acid sequence of SEQ ID NO:11 and the heavy chain consists of the amino acid sequence of SEQ ID NO:9.
  • Described herein is an isolated antibody wherein the light chain consists of the amino acid sequence of SEQ ID NO:7 and the heavy chain consists of the amino acid sequence of SEQ ID NO:13.
  • Described herein is an isolated antibody wherein the light chain consists of the amino acid sequence of SEQ ID NO:11 and the heavy chain consists of the amino acid sequence of SEQ ID NO:13.
  • the antibody is stable at 37°C for a period of at least 12 hours.
  • Described herein are methods for treating subjects having a CD40L-associated disease or disorder comprising administering to the subject a therapeutically effective amount of an antibody described herein.
  • an antibody, or mixtures thereof can be administered to the subject as a monotherapy, which, as used herein, means that the antibody is the only therapeutic agent administered to the patient that is directed to the treatment of the underlying disease or disorder.
  • Monotherapy using an antibody described herein does not preclude the administration of other drugs, non-limiting examples of which are muscle relaxants, nonsteroidal anti-inflammatory drugs, pain medications, and antidepressants. Accordingly, one or a mixture of the antibodies described herein, is the sole therapeutic agent directed to treatment of the underlying disease or disorder.
  • the antibodies, or mixtures thereof can be administered in combination with other therapeutic agents.
  • “In combination with” includes, but is not limited to, administration of the therapeutic agents at different times, at different frequencies, simultaneously, or combined in a single dosage form.
  • Neurodegenerative or neuromuscular diseases and disorders include, but are not limited to, Alzheimer's Disease, Parkinson's Disease, Amyotrophic Lateral Sclerosis, Multifocal Motor Neuropathy, Primary Lateral Sclerosis, Spinal Muscular Atrophy, Kennedy's Disease, and Spinocerebellar Ataxia.
  • Described herein is a method for treating a subject with Amyotrophic Lateral Sclerosis comprising administering to the subject a therapeutically effective amount of an antibody described herein.
  • Inflammatory or immune diseases and disorders include, but are not limited to, colitis, drug induced lupus nephritis, graft versus host disease, transplant rejection and atherosclerosis
  • Autoimmune diseases include, but are not limited to systemic lupus erythematous, type-1 diabetes, myasthenia gravis, inflammatory bowel disease, immune thrombocytopenic purpura and rheumatoid arthritis.
  • Described herein is method of inhibiting an immune response in a subject comprising administering to the subject a therapeutically effective amount of an antibody described herein.
  • the immune response may be graft vs. host disease.
  • the immune response may be organ transplant rejection.
  • an antibody is administered as a monotherapy.
  • the antibody is JB5 is administered as monotherapy.
  • the antibody JB5-K74R is administered as monotherapy. Described herein the antibody JB5-R28K is administered as monotherapy. Described herein the antibody JB5- R28K-K74R is administered as monotherapy.
  • the antibody is administered in combination with another therapeutic agent.
  • the antibody is administered in combination with a compound that blocks the interaction between CD28 and CD86 or between CD28 and CD80.
  • the compound that blocks the interaction between CD28 and CD86 or between CD28 and CD80 is a CTLA4-Ig fusion protein. In one embodiment the compound that blocks the interaction between CD28 and CD86 or between CD28 and CD80 is abatacept or belatacept or galiximab.
  • compositions and methods of administration are provided.
  • compositions for use in accordance with the methods of the present disclosure may be formulated in a conventional manner using one or more physiologically acceptable carriers.
  • Pharmaceutically acceptable carriers are determined in part by the particular composition being administered, as well as by the particular method used to administer the composition. Accordingly, there are a wide variety of suitable formulations of the compounds useful in the methods of the present disclosure (see, e.g., Remington: The Science and Practice of Pharmacy, 20th ed., Gennaro et al. Eds., Lippincott Williams and Wilkins, 2000 ).
  • Formulations suitable for parenteral administration include aqueous and non-aqueous, isotonic sterile injection solutions, which can contain antioxidants, buffers, bacteriostats, and solutes that render the formulation isotonic with the blood of the intended recipient, and aqueous and non-aqueous sterile suspensions that can include suspending agents, solubilizers, thickening agents, stabilizers, and preservatives.
  • the compounds can be administered by any suitable means, which can vary, depending on the type of disorder being treated and on the nature of the compound itself.
  • administration routes preferably include parenteral, e.g., intramuscular, intravenous, intraarterial, intraperitoneal, or subcutaneous.
  • parenteral dosing is given by injection, most preferably intravenous, intramuscular or subcutaneous injection.
  • the amount to be administered will depend on a variety of factors such as the clinical symptoms, weight of the individual, and whether other drugs are administered. It should be appreciated that determination of proper dosage forms, dosage amounts, and routes of administration is within the level of ordinary skill in the pharmaceutical and medical arts.
  • nucleic acid sequences encoding the heavy chain and the light chain of the desired antibody were designed to be suitable for expression in mammalian cells such as Chinese Hamster Ovary (CHO) cells.
  • the nucleic acids were then artificially synthesized and ligated into the antibody expression vector BPJPuro using standard molecular biology techniques.
  • BPJPuro is a dual gene mammalian expression vector optimized for selectable and stable expression of immunoglobulins in Chinese Hamster Ovary (CHO) cells. The vector is then transfected into CHO cells and stable transfectants selected.
  • the resulting expression vector encoding the heavy and light chains was transfected into the CHO line (CHO SA, Cellectis SA, Paris, France) using liposome mediated transfection. Stable transfectants were isolated by puromycin selection and subcloned to provide clonal cell lines. Candidate cell lines were adapted to serum free suspension culture and screened for IgG production and robust growth. One of the cell lines was selected and named JB5, the cell line was cultured in a pilot scale bioreactor and the antibody JB5 was purified from conditioned medium by sequential concentration, Protein A/G affinity chromatography, and size exclusion chromatography.
  • a three part sandwich ELISA assay was used to determine binding kinetics of the JB5 antibody relative to the parental antibody hu5c8. All washes were performed using 3 washes of 250 ⁇ l of PBS.
  • a 96-well polystyrene plate was coated with 100 ⁇ l/well of JB5 or hu5c8 antibody (2 ⁇ g/ml) for 16 hours at 4°C. The plate was washed and then blocked with 2% bovine serum albumin/PBS for 1 hour at room temperature. The plate was washed and recombinant human CD40L protein (Santa Cruz Biotechnology, Santa Cruz, California, USA) was added to the plate titrated out by 2-fold dilution starting at 2000 ng/ml.
  • the bound CD40L protein was detected using 100 ⁇ l a biotinylated goat anti-human CD40L polyclonal antibody (200 ng/ml) and 100 ⁇ l a streptavidin-horseradish peroxidase conjugate at 100 ng/ml. Colorimetric detection was performed with the chromagen TMB (3,3',5,5'-tetramethylbenzidine) and spectrophotometric analysis of absorption at 450 nm. The resulting binding curves ( Figure 3 ) show that JB5 (circle) has highly similar CD40L binding relative to the parental antibody hu5c8 (square).
  • the control protein CTLA4-IgGl (triangle), having the same Fc domain as JB5 showed no significant binding.
  • the calculated EC50 for hu5c8 and JB5 is 114 and 137 nM, respectively.
  • JB5-R28K and JB5-K74R showed binding similar to that of JB5.
  • a solid phase ELISA binding assay was performed to determine the level of binding of four human Fc gamma receptor isoforms to the parental hu5c8 antibody.
  • 100 ⁇ l/well hu5c8 antibody (2 ⁇ g/ml in phosphate buffered saline) was added to the wells of a 96 well polystyrene plate and incubated for 16 hours at 4 °C.
  • the plate was blocked and recombinant human Fc gamma receptor (FCGR) proteins (Santa Cruz Biotechnology, Santa Cruz, California) titrated by 2-fold dilution with a starting concentration of 5 ⁇ g/ml.
  • FCGR human Fc gamma receptor
  • FCGR1A CD64
  • FCGR2A CD32
  • FCGR3A CD16a
  • FCGR3B CD16b
  • FCGR FCGR isoform specific murine monoclonal antibody
  • FCGR horseradish peroxidase conjugate goat anti-mouse IgG detector antibody.
  • Colorimetric detection was performed with the chromagen TMB (3,3',5,5'-tetramethylbenzidine) and spectrophotometric analysis of absorption at 450 nm.
  • the resulting binding curves demonstrate that the parental hu5c8 antibody binds the high affinity FCGR1A (circle, solid line) receptor and the FCGR2A receptor (circle, dotted line) expressed on activated platelets, with high affinity.
  • the hu5c8 antibody showed no binding to the FCR3A or FCR3B isoforms.
  • a solid phase binding assay was used to test binding of human Fc gamma receptor isoforms to the mutant JB5 antibody.
  • 100 ⁇ l/well JB5 (2 ⁇ g/ml in phosphate buffered saline) was coated for 16 hours onto a 96 well polystyrene plate.
  • the plate was blocked and recombinant human Fc gamma receptor (FCGR) proteins (Santa Cruz Biotechnology, Santa Cruz, California) titrated onto by 2-fold dilution with a starting concentration of 5 ⁇ g/ml.
  • FCGR human Fc gamma receptor
  • FCGR1A CD64
  • FCGR2A CD32
  • FCGR3A CD16a
  • FCGR3B CD16b
  • JB5 lacks three of the disulfide linkages in wild-type IgG1 antibodies, JB5 was tested using size exclusion chromatography to determine if the antibody was stable, i.e., existed as a tetrameric, fully intact antibody. Hu5c8, which has the three disulfide linkages was used as a control.
  • the mobile phase was PBS and the elution rate was 1.0 mL/minute and the absorbance was measured at 280 nm.
  • JB5 had an observed molecular weight of 183 kDa ( Figure 6 ) and hu5c8 ( Figure 7 ) had a MW of 164 kDa consistent with the antibody being in the tetrameric, divalent form.
  • the observed 19 kDa difference between the hu5c8 antibody and JB5 may be due to increased glycosylation of the Fc domain of JB5.
  • the antibody was assayed for its ability to induce the platelet cell surface marker protein PAC-1.
  • Whole blood was drawn from three healthy volunteers into 3.2% Na citrate tubes discarding the first 2 ml. Platelet rich plasma was prepared by centrifugation for 15 minutes at 120 g the platelet count was normalized with phosphate buffered saline to 1 ⁇ 10 5 cells/ml.
  • Immune complexes of recombinant human CD40L (Santa Cruz Biotechnology, Santa Cruz, CA, USA) and the test antibodies, hu5c8, JB5, and hu5c8 F(ab') 2 were prepared at a CD40L:Antibody molar ratio of 3:1 (0.6944 nmole CD40L:0.2315 nmole antibody) by preincubation at room temperature for 15 minutes.
  • the immune complex mixture was diluted to a final concentration of 5 ⁇ g/ml CD40L in the normalized PBS/platelet solution and incubated at 37°C for 30 minutes. Negative controls were untreated platelets and CD40L alone.
  • the platelet activation positive control was prepared by the addition of ADP to a final concentration of 20 micromolar in the normalized PBS-platelet solution. After 30 minutes of incubation, anti-human PAC-1-FITC conjugated antibody was added to all samples and incubated for 15 minutes. Samples were diluted 1:1 into 2% paraformaldehyde:PBS buffer, fixed on ice for 30 minutes, centrifuged at 100 g, for 5 minutes to pellet the cells. The cells were resuspended in PBS. Fluorescence activated cell sorting (FACS) was performed on a Guava easyCyte flow cytometer (EMD Millipore, Inc., Billerica, MA, USA). Post-acquisition analysis was performed using FlowJo software (FlowJo, LLC, Ashland, OR, USA).
  • FACS Fluorescence activated cell sorting
  • FIG. 14 shows the platelet activation results from three persons' platelets after incubation of the platelets with 20 ⁇ M ADP, 5 ⁇ g/ml CD40L, the immune complex of CD40L and hu5c8, the immune complex of CD40L and JB5 antibody or the immune complex of CD40L with hu5c8 F(ab') 2 .

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US11692040B2 (en) 2023-07-04
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